CQC report explained · a residential care home
What the CQC found at St Christopher's Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments and care records did not always contain enough information or show that required checks had been completed. Inspectors also found unanswered call bells, gaps in medicines records, incomplete injury records and gaps in cleaning records.
- Effective?
- Good
- This question was not inspected during this focused inspection. The rating from the previous comprehensive inspection was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. The rating from the previous comprehensive inspection was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused inspection. The rating from the previous comprehensive inspection was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Audits and other checks did not identify important gaps in care records, medicines records, food and fluid monitoring or cleaning records. Inspectors said management systems were not effective or robust enough to monitor quality and safety.
What inspectors found, February 2021
St Christopher's Home is rated Requires Improvement; inspectors found risks, medicines and oversight were not consistently managed safely.
This was a focused inspection on 27 January 2021 after concerns about staffing and pressure sores. Inspectors reviewed care and medicine records, staff files and management records. They spoke with relatives and staff, but could not speak with residents because of COVID-19 risks.
Inspectors found gaps in risk assessments, pressure care, food and fluid records, injury records and medicines records. Call bells went unanswered for more than 10 minutes on three occasions. Cleaning records were also incomplete, although the home appeared clean.
Staff were recruited safely and relatives spoke positively about the kindness of staff. The home helped residents keep in touch with families during the pandemic. However, systems for checking quality and safety did not find or correct the problems. The overall rating fell from Good to Requires Improvement.
Safe recruitment
The home completed pre-employment checks, including references and criminal record checks. Checks were also in place for agency staff.
“Staff were recruited safely. The provider completed pre employment checks such as references and Disclosure and Barring Service (DBS) checks.” from the report
Kind staff
Relatives and residents who were spoken with described staff positively and said they knew people well.
“People and their relatives spoke positively about the care their loved one received.” from the report
Family contact
The home supported residents to keep in touch with relatives during the pandemic through calls, video chats and outdoor visits.
“People were supported to stay in contact with their family during the pandemic via phone calls, video chats and outdoor visiting.” from the report
Open to feedback
The manager and staff were open during the inspection. The manager sent evidence of improvements made immediately afterwards.
“The registered manager was open to feedback and sent us evidence of improvements they made immediately after the inspection.” from the report
Risk records and care checks
seriousCare plans and risk assessments did not always explain what staff needed to do. Records did not consistently show checks for diabetes, fluids or repositioning, increasing the risk of dehydration and pressure damage.
“We found evidence that not all people reached their required daily amount of fluids. This put people at increased risk of dehydration.” from the report
Medicines records
seriousMedicine administration records had gaps. Staff did not always sign or date changes, and stock checks were not evidenced, creating a risk that people might not receive medicines as prescribed.
“This put people at risk of not receiving their medicines as prescribed.” from the report
Call bell response and staffing
needs fixingSome staff and relatives said response times could be slow. Call bells were unanswered for more than 10 minutes on three occasions.
“Call bells were found to be unanswered for periods of time over 10 minutes on three separate occasions.” from the report
Weak quality checks
seriousAudits did not identify problems in care records, medicines, food and fluid monitoring or cleaning records. This was a breach because the systems did not adequately monitor safety.
“This placed people at risk of harm.” from the report
Incomplete cleaning records
minorInfection control measures were in place, but cleaning schedules had several recording gaps. Inspectors were not assured that the home could effectively prevent or manage infection outbreaks.
“We found multiple gaps of recording on the cleaning schedules.” from the report
- 01What action has been taken to make sure pressure care and repositioning records are complete?
- 02How do you now check that residents receive their required food and fluid intake?
- 03What changes have been made to medicine administration records and medicine stock checks?
- 04How many staff are usually on duty, and how quickly are call bells answered now?
- 05How do your current audits identify and correct problems in care, medicines and cleaning records?
This was a focused inspection of Safe and Well-led, including infection prevention and control under Safe; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 24 February 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2018
St Christopher's Home was rated Good overall, but inspectors found weaknesses in quality checks, medicine records and reporting incidents to the CQC.
The inspection was unannounced and took place on 21 March 2018. One inspector spoke with people living at the home, relatives, staff and managers. They reviewed care records, staff files and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, suitable recruitment checks, trained staff, personalised care and respectful support. People were involved in their care and could raise concerns.
The well-led rating was Requires Improvement. The home had quality checks, but did not always act on problems. Medicine records had gaps for some creams, and two safeguarding alerts had not been reported to the CQC promptly. The home remained Good overall, as it had been at the February 2016 inspection.
Enough staff
Inspectors found staffing levels were sufficient and people received prompt support. Staff were also available to provide activities and conversation.
“There were enough staff on shift to make sure people were safe, and to provide meaningful activity and conversation.” from the report
Kind and respectful care
Staff knew people's needs and preferences and treated them with dignity. Inspectors saw positive interactions and respectful privacy during personal care.
“We observed staff interact with people in a positive manner.” from the report
Personalised support
Care plans included people's histories, likes, dislikes and preferences. People and families were involved in decisions and reviews.
“Care plans we looked at contained a personal history about the person, as well as likes, dislikes and preferences.” from the report
Staff training and support
Staff received induction, ongoing training and regular supervision. The home also arranged specialist training, including end of life care.
“All staff received regular supervision from management.” from the report
Quality checks did not lead to improvement
needs fixingAudits had identified missing information in some medicine records, but the problem continued for several months. The manager said daily checks would now be introduced.
“We found that whilst all areas of the service were monitored, actions were not always taken and improvements were not always made.” from the report
Some medicine records were incomplete
needs fixingSeveral records for topical medicines and skin barrier creams had gaps. This meant it was not always clear whether the medicine had been given as prescribed.
“We saw that several records had gaps where we could not tell if the medicine was given as prescribed or not.” from the report
Safeguarding alerts were not reported promptly
seriousTwo safeguarding alerts sent to the local authority had not also been notified to the CQC in time. The managers said they would submit the information retrospectively and report future concerns promptly.
“The service had notified the CQC appropriately on most occasions, but had failed to do so for two recent safeguarding alerts they had raised with the local authority.” from the report
- 01What daily checks are now being made to ensure topical medicine and skin cream records are complete?
- 02How do you now make sure safeguarding incidents are reported to the CQC promptly?
- 03What action is taken when your quality audits identify a problem that has not been corrected?
- 04How will my relative and our family be involved in care planning and reviews?
- 05What specialist training do staff receive if my relative needs end of life care?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home. This explanation was written from the published report of 26 April 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of St Christopher's Home
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- February 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2018Goodstayed GoodSafe: GoodWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 31 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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